台灣與美國身心障礙兒童早期療育政策之比較研究

本研究的目的在探討台灣與美國早期療育政策的發展進程及實施概況，比較分析兩國所實施早期療育政策之異同，最後提供我國早期療育政策具體改善的建議。藉由文件與文獻分析法及G. Z. F. Bereday比較教育研究法，瞭解兩國早期療育政策的發展演進內涵、政策實施概況，及保障學前身心障礙兒童接受早期療育權利的相關措施。自1965年起，美國開始重視到早期療育對於學前身心障礙兒童的發展，1975年至1990年，聯邦政府除了要求3至21歲適齡兒童提供免費且適性的公共教育之外，更規定各州政府應提供出生至3歲有身心障礙的嬰幼兒早期療育的服務，以及提供3歲至5歲有身心障礙的兒童學前特殊教育與相關服務。1990年至今，美國聯邦政府除了擴大了對身心障礙兒童早期療育服務的相關內容，包括鑑定程序、個別化教育、轉銜服務及家長參與等方面之外，更要求各州政府必須為身心障礙兒童及其家庭建立完善的早期療育服務系統。在我國，早期療育三大法律基礎分別是「特殊教育法」、「兒童及少年福利法」以及「身心障礙者保護法」。在法律的基礎下，主要由內政部兒童局、教育部及衛生署三大單位制定和推動相關的政策和措施。自1997年至今，我國早期療育政策之推行日漸完備，除了率先訂定早期療育服務之流程及設置早期療育相關機構之外，更增加了轉銜服務、專業團隊服務、特殊教育相關專業研究所、個案管理系統、學前特殊教育實施方案、醫療補助計畫、到宅服務、融合式教保服務、巡迴輔導服務、學前啟蒙服務計畫等相關政策和方案，以建立更完善的早期療育服務系統。本研究第一章為緒論，主要描述本研究之背景、動機、目的及方法等。第二章為文獻探討，主要探討早期療育的意涵及重要性、介入策略的理論模式及專業團隊服務模式。第三章與第四章則分別探究美國與台灣早期療育政策實施演進及現況分析。第五章則為兩國早期療育政策之比較分析，最後在第六章，則提出相關結論與建議。本研究兩大主要發現在於：一、兩國早期療育政策皆以最少限制的環境為教育安置原則、提供相關補助經費、實施啟蒙教育方案、擬定個別化教育計畫、個別化家庭服務計畫、重視輔助科技服務、訂定鑑定評估事宜、重視專業團隊服務及強調轉銜服務。二、兩國早期療育政策之主要差異在於，早期療育安置原則、家長參與權利、早期療育師資培育、鑑定評估方式、身心障礙兒童的發現、通報和轉介機制。

關鍵字

早期療育；美國教育；早期療育政策

並列摘要

The research mainly aims to probe the development and practice of early intervention policies in Taiwan and U. S. A., compare the similarity and the difference of early intervention policies between Taiwan and U. S. A., and finally afford some suggestions for the implementation of early intervention in Taiwan. By using document and literature analysis and G. Z. F. Bereday comparison research methods to understand the developmental contents and practical conditions ensure disability children have the rights to accept early intervention of early intervention policies in Taiwan and U. S. A. Since 1965, U. S. A. started to pay attention to early intervention can affect the development of disability children. From 1975 to 1990, federal government provided free appropriate public education to 3 to 21 years old disability students, provided early intervention services to 0 to 3 years old disability infants, and provided preschool special education to 3 to 5 years old disability children. From 1990 to now, federal government expanded the related contents of early intervention services and askes state governments have to establish a completed early intervention system. In our country, early intervention services are based on “The Act of Special Education”,” Children and Youth Welfare Act”, and “Physically and Mentally Disabled Citizens Protection Act”. Under the three acts, Children’s Bureau Minstry of the Interior, Minstry of Education, and Department of Health established related policies and measures. Since 1997, early intervention policies in our country became more completed, enacted the procedure andrelated institutions, and added many programs of early intervention services. The thesis includes six chapters. The first chapter is interduction mainly describe the background, motive, intention and methods of the study. The second chater is literature analysis mainly represent the meaning, theory, and disciplinary models of early intervention. The third and fourth chapter is about the development and practice of early intervention policies in Taiwan and U. S. A. The sixth chapter is conclusion and suggestion. There are two major discovers in the research. One is early intervention policies in the two countries all paied attention to the least restrictive environment is the education setting principle, provided related funding, practiced head start program, designed individualized educational plan and individualized family service plan, offered assistive technology services, emphasized disciplinary team and transition service. Another one is the differents of the early intervention policies in the two countries are early intervention setting principle, the right of parents, early intervention teacher education, the way of evaluation and assessment, and the child find system.